You can earn points when you reach specific Performance Targets or Improvement Targets for your patients who are UnitedHealthcare® Medicare Advantage members. Payments are based on your total earned Performance Points at the end of the year.
As part of this incentive, your practice can earn an annual bonus when you achieve at least 40+ points.
| Earning tiers | PMPY (Per MA-PCPi member per year) |
|---|---|
| 100+ | $400 |
| 95–99 | $350 |
| 90–94 | $300 |
| 85–89 | $250 |
| 80–84 | $200 |
| 75–79 | $150 |
| 70–74 | $125 |
| 65–69 | $100 |
| 60–64 | $75 |
| 55–59 | $60 |
| 50–54 | $45 |
| 45–49 | $30 |
| 40-44 | $20 |
| Fewer than 40 | $0 |
| Quality Care Measure | Tier 1 (Hit target) | Tier 2 (Hit target) | OR |
Improvement Target | |||
|---|---|---|---|---|---|---|---|
| Point value | Target | Point value | Target | Point value | Improvement | ||
BCS-E |
3 |
77% |
2 |
85% |
5 |
5% |
|
COL-E |
3 |
75% |
2 |
83% | 5 |
5% |
|
EED |
3 |
78% |
2 |
84% | 5 |
5% |
|
GSD |
5 |
89% |
5 |
94% | 10 |
7% |
|
CBP |
5 |
86% |
5 |
91% | 10 |
8% |
|
PCR |
5 |
9% |
5 |
7% | 10 |
2% |
|
KED |
3 |
71% |
2 |
81% | 5 |
10% |
|
FMC |
3 |
69% |
2 |
80% | 5 |
7% |
|
MRP |
3 |
77% |
2 |
90% | 5 |
10% |
|
POLY ACH*** |
3 |
7% |
2 |
4% | 5 |
3% |
|
MAD |
3 |
90% |
2 |
93% | 5 |
4% |
|
MAH |
3 |
92% |
2 |
94% | 5 |
3% |
|
MAC |
3 |
91% |
2 |
94% | 5 |
3% |
|
SUPD |
5 |
91% |
5 |
94% | 10 |
5% |
|
Getting Needed Care |
3 |
93% |
2 |
95% | 5 |
3% |
|
Care Coordination |
3 |
92% |
2 |
94% | 5 |
3% |
|
* The information in these columns is subject to change from time to time at CMS’ discretion. If CMS retires a Quality Care Measure or moves it to “display status,” UnitedHealthcare reserves the right to remove it from this bonus opportunity
** For final evaluation of the Performance Point Bonus, UnitedHealthcare has the right to adjust the targets for these measures based on national historic performance as long as the adjustment benefits the provider.
***Polypharmacy: Use of Multiple Anticholinergic Medications in Older Adults
Your practice can earn Extra Credit Points for meeting or exceeding the metric(s) defined below. Extra Credit Points are added in addition to the points total
| Extra credit metric | Period | Points value |
|---|---|---|
| Concurrent Use of Opioids and Benzodiazepines compliance at 11% or lower | Current calendar year | 3 |
This example is based on a practice’s 2026 MA-PCPi year-end performance. Their total Performance Point Bonus is 67, which would qualify them to earn the $100 PMPY bonus.
| Quality Care Measure | Measure Performance Percentage | Prior year measure Performance Percentage | Tier achieved | Points achieved |
|---|---|---|---|---|
| Breast Cancer Screening (BCS-E) |
76% | 65% | Improvement | 5 |
| Colorectal Cancer Screening (COL-E) | 76% | 72% | Tier 1 | 3 |
| Eye Exam for Patients With Diabetes (EED) | 90% | 88% | Tier 1 & Tier 2 | 5 |
| Glycemic Status Assessment for Patients with Diabetes (GSD) | 90% | 86% | Tier 1 | 5 |
| Controlling Blood Pressure (CBP) | 65% | 61% | 0 | |
| Medication Reconciliation Post-Discharge (MRP) | 71% | 69% | 0 | |
| Plan All-Cause Readmissions (PCR) | 7% | 8% | Tier 1 & Tier 2 | 10 |
| Follow-up after Emergency Department Visit for Patients with Multiple Chronic Conditions (FMC) | 87% | 89% | Tier 1 & Tier 2 | 5 |
| Polypharmacy: Use of Multiple Anticholinergic Medications in Older Adults (Poly ACH) | 10% | 11% | 0 | |
| Kidney Health Evaluation for Patients With Diabetes (KED) | 75% | 55% | Tier 1 & Improvement | 5 |
| Medication Adherence for Diabetes Medications (MAD) | 93% | 91% | Tier 1 & Tier 2 | 5 |
| Medication Adherence for Hypertension (RAS antagonists) (MAH) | 88% | 86% | 0 | |
| Medication Adherence for Cholesterol (Statins) (MAC) | 91% | 90% | Tier 1 | 3 |
| Statin Use in Persons with Diabetes (SUPD) | 85% | 78% | Improvement | 10 |
| Getting Needed Care | 94% | 92% | Tier 1 | 3 |
| Care Coordination | 90% | 85% | Improvement | 5 |
| Total points | 64 | |||
| Extra credit metric | Performance Percentage | Outcome | Points achieved | |
Concurrent Use of Opioids and Benzodiazepines compliance at 11% or lower |
10% | Metric met | 3 | |
| Total points + extra credit | 67 | |||
If there is a conflict between this page and the Terms and Conditions, the Terms and Conditions control.